SESSION OF 2021
SUPPLEMENTAL NOTE ON SUBSTITUTE FOR SENATE
BILL NO. 238
As Amended by House Committee on Health
and Human Services

Brief*
Sub. for SB 238, as amended, would establish
certification for certified community behavioral health clinics
(CCBHCs) and prescribe the powers, duties, and functions of
the Kansas Department for Aging and Disability Services
(KDADS) with regard to CCBHCs. The bill would also
authorize a licensed out-of-state physician with a
telemedicine waiver issued by the State Board of Healing Arts
(BOHA) to practice telemedicine in Kansas. The bill would
also amend the disciplinary authority of the Behavioral
Sciences Regulatory Board (BSRB) and modify licensure and
temporary permit requirements of professional counselors,
social workers, marriage and family therapists, addiction
counselors, psychologists, and master’s level psychologists.
The bill would also make technical amendments.

KDADS Responsibilities for CCBHC Certification (New
Section 1)
The bill would require KDADS to establish a process to
certify CCBHCs.
The bill would require KDADS to certify as a CCBHC
any community mental health center (CMHC) licensed by
KDADS that provides the following services: crisis services;
screening, assessment, and diagnosis, including risk
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
assessment; person-centered treatment planning; outpatient
mental health and substance use services; primary care
screening and monitoring of key indicators of health risks;
targeted case management; psychiatric rehabilitation
services; peer support and family supports; medication-
assisted treatment; assertive community treatment; and
community-based mental health care for military service
members and veterans.

Implementation Schedule
The bill would establish a staggered implementation
schedule for CCBHC certification and require KDADS,
subject to certification applications, to certify:
● Six facilities currently receiving grants to operate
as CCBHCs by no later than May 1, 2022;
● Three additional facilities by no later than July 1,
2022;
● Nine additional facilities by no later than July 1,
2023; and
● Eight additional facilities by no later than July 1,
2024.
The bill would authorize KDADS to certify CCBHCs,
including portions of the specified facility numbers, in
advance of the above-cited deadlines.
KDADS Rules and Regulation Authority
The bill would authorize KDADS to adopt rules and
regulations as necessary to implement and administer
provisions related to CCBHCs.


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Out-of-state Telemedicine Practice (New Section 2)
The bill would authorize a physician holding a license
issued by the applicable licensing agency of another state or
who otherwise meets the requirements of the bill to practice
telemedicine to treat patients located in Kansas if the
physician receives a telemedicine waiver issued by the
BOHA. The bill would require the BOHA to issue the waiver
within 15 days from receipt of a complete application, if the
physician:
● Submits a complete application, which may include
an affidavit from an authorized third party that the
applicant meets the requirements, in a manner
determined by the BOHA, and pays a fee not to
exceed $100; and
● Holds an unrestricted license to practice medicine
and surgery in another state or meets the
qualifications required under Kansas law for a
license to practice medicine and surgery and is not
the subject of any investigation or disciplinary
action by the applicable licensing agency.
The bill would require a physician to practice
telemedicine in accordance with the bill to conduct an
appropriate assessment and evaluation of a patient’s current
condition and document an appropriate medical indication for
any prescription issued.
The bill would not supersede or affect the provisions of
KSA 65-4a10 (Performance of abortions restricted to a
physician licensed to practice medicine in Kansas) or KSA
2020 Supp. 40-2,210 et seq. (Kansas Telemedicine Act).


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Rules and Regulations for Telemedicine Waivers
The bill would require any person who receives a
telemedicine waiver to be subject to all rules and regulations
pertaining to the practice of the licensed profession in Kansas
and be considered a licensee for the purposes of the
professional practice acts administered by the BOHA. The bill
would also require any waiver issued to expire on the date
established, unless renewed by the BOHA upon receipt of
payment of an annual renewal fee not to exceed $100 and
evidence that the applicant continues to meet the
qualifications of the bill. The bill would not prohibit a licensing
agency from denying a waiver application if the licensing
body determines granting the application may endanger the
health and safety of the public.
Out-of-state Authorizations
The bill would authorize:
● A physician holding a license issued by the
applicable licensing agency of another state to
provide, without limitation, consultation through
remote technology to a physician licensed in
Kansas; and
● An applicable health care licensing agency of this
state to adopt procedures consistent with this
section to allow other health care professionals
licensed and regulated by the licensing agency to
practice telemedicine within the profession’s scope
of practice by Kansas law as deemed by the
licensing agency to be consistent with ensuring
patient safety.


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Definition of Telemedicine
The bill would define “telemedicine” to mean the delivery
of health care services by a health care provider while the
patient is at a different physical location.

Clinical Professional Counselor Licensure (Section 3)
The bill would amend the licensure requirements to
become a clinical professional counselor to:
● Reduce from 350 to 280 the minimum number of
hours of direct client contact or additional
postgraduate supervised experience as determined
by the BSRB;
● Reduce from 4,000 to 3,000 the minimum number
of hours of supervised professional experience;
● Reduce from 150 to 100 the minimum number of
hours of face-to-face clinical supervision as defined
by the BSRB in rules and regulations;
● Require no less than 50 of the face-to-face clinical
supervision hours to include individual supervision,
although the BSRB could waive:
○ The requirement such supervision be face-to-
face upon finding extenuating circumstances;
and
○ Half of the required hours for an individual
who has a doctoral degree in professional
counseling or a BSRB-approved related field
and who completes half of the required hours
in one or more years of supervised
professional experience;
● Specify a temporary license may be issued after
the applicant pays the temporary license fee; and

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 ● Increase from 6 to 12 the number of months after
issuance a temporary license would expire, absent
extenuating circumstances approved by the BSRB.
Clinical Social Work Licensure (Section 7)
The bill would amend requirements to become a
licensed specialist clinical social worker to:
● Remove the requirement an individual complete
350 hours of direct clinical contact or additional
postgraduate supervised experience as determined
by the BSRB;
● Specify the 100 hours of clinical supervision would
be face-to-face, as defined by the BSRB in rules
and regulations; and
● Require the 100 hours of face-to-face clinical
supervision to include no less than 50 hours of
individual supervision, although the BSRB could
waive the requirement such supervision be face-to-
face upon finding extenuating circumstances.
Clinical Marriage and Family Therapist Licensure
(Section 10)
The bill would amend the licensure requirements to
become a clinical marriage and family therapist to:
● Reduce from 4,000 to 3,000 the number of hours of
supervised professional experience;
● Reduce from 150 to 100 the minimum number of
hours of clinical supervision and specify such hours
be face-to-face, as defined by the BSRB in rules
and regulations; and

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 ● Require the face-to-face clinical supervision hours
include no less than 50 hours of individual
supervision, although the BSRB could waive:
○ The requirement such supervision be face-to-
face upon finding extenuating circumstances;
and
○ Half of the required hours for an individual
who has a doctoral degree in marriage and
family therapy or a BSRB-approved related
field and who completes half of the required
hours in one or more years of supervised
professional experience.
Clinical Addiction Counselor Licensure (Section 14)
The bill would amend the licensure requirements to
become a clinical addiction counselor to:
● Reduce from 4,000 to 3,000 the minimum number
of hours of supervised professional experience;
● Reduce from 150 to 100 the minimum number of
hours of clinical supervision and specify such hours
be face-to-face, as defined by the BSRB in rules
and regulations;
● Require the face-to-face clinical supervision hours
to include no less than 50 hours of individual
supervision, although the BSRB could waive:
○ The requirement such supervision be face-to-
face upon finding extenuating circumstances;
and
○ Half of the required hours for an individual
who has a doctoral degree in addiction
counseling or a BSRB-approved related field
and who completes half of the required hours
in one or more years of supervised
professional experience.
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Clinical Psychotherapist Licensure (Section 19)
The bill would amend the licensure requirements to
become a clinical psychotherapist to:
● Reduce from 4,000 to 3,000 the minimum number
of hours of supervised professional experience;
● Reduce from 150 to 100 the minimum number of
hours of clinical supervision and specify such hours
be face-to-face, as defined by the BSRB in rules
and regulations; and
● Require the face-to-face clinical supervision hours
include no less than 50 hours of individual
supervision, although the BSRB could waive the
requirement such supervision be face-to-face upon
finding extenuating circumstances.
Temporary Permits (Sections 4, 8, 11, 15, 17, and 20)
The bill would amend the requirements for professional
counselors, clinical social workers, clinical marriage and
family therapists, clinical addiction counselors, psychologists,
and clinical master’s level psychologists licensed in another
jurisdiction to practice in Kansas under a temporary permit to:
● Require individuals to have practiced in their
jurisdiction for at least two years immediately
preceding the application, except clinical social
workers must only have practiced in their
jurisdiction, without the two-year requirement;
● Increase from 15 to 30 the maximum number of
days per year the individual could practice in
Kansas; and


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 ● Require the individual to provide quarterly reports
to the BSRB detailing the total days of practice in
Kansas.
The bill would also specify the temporary practice permit
would expire one year after issuance, and the BSRB could
extend the permit for no more than one additional year upon
the individual’s written application no later than 30 days
before the permit’s expiration and under emergency
circumstances, as defined by the BSRB. The bill would
provide that any extended permit would authorize the
individual to practice in Kansas for an additional 30 days
during the additional year and require the individual to
provide quarterly reports to the BSRB detailing the total days
of practice in Kansas.

Board License Refusal and Revocation Authorities
(Sections 6, 9, 12, 16, 18, and 21)
The bill would amend the reasons the BSRB may refuse
to issue, renew, reinstate, condition, limit, revoke, or suspend
a professional counseling, social work, marriage and family
therapy, addiction counseling, psychology, or master’s level
psychology license or censure or impose a fee on such
licensee to:
● Remove reference to specific professions and
specify the condition whether the individual has
had any professional registration, license, or
certificate revoked, suspended, or limited, or has
had other disciplinary action taken, or an
application for registration, license, or certification
denied, by the proper regulatory authority of
another state, a territory, District of Columbia, or
another country;
● Add the District of Columbia as another location
where a substantiated finding of abuse and neglect
would result in an individual being listed on a child

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 abuse registry or an adult protective services
registry, except the District of Columbia is not
included with regard to psychologists; and
● Add the condition whether the individual has
violated any lawful order or directive of the BSRB.
Clinical Supervisor Application Fee (Sections 5 and 13)
The bill would authorize the BSRB to establish, by rules
and regulations approved by the BSRB, a maximum $50 fee
for an application for approval as a BSRB-approved clinical
supervisor of professional counselors or marriage and family
therapists.

Background
SB 238, as introduced, would have amended the
disciplinary authority of BSRB and modified licensure and
temporary permit requirements of several professions. The
Senate Committee on Public Health and Welfare
recommended a substitute bill that incorporates the
provisions of SB 238 as amended by the Senate Committee
and the provisions of SB 138 (CCBHC certification and
funding).

Senate Committee on Public Health and Welfare
SB 138 Hearing
In the Senate Committee hearing on SB 138 on
February 23, 2021, representatives of the Association of
Community Mental Health Centers of Kansas, COMCARE,
Four County Mental Health Center, Johnson County Mental
Health Center, the Kansas Mental Health Coalition, and the
Kansas Sheriffs Association provided proponent testimony.
The proponents generally stated the CCBHC model would
provide a comprehensive range of mental health and
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substance use disorder 24-hour crisis care services and
receive an enhanced Medicaid reimbursement rate based on
the anticipated costs of expanding services to meet the needs
of these complex populations. The proponents noted the
state’s shortage of mental health professionals, which is
further challenged by being surrounded on all four borders by
states that have either expanded Medicaid, implemented the
CCBHC model, or both, which provides those states with
additional resources and the ability to recruit away already
scarce Kansas behavioral health professionals. The
proponents also noted an increased demand for services and
stagnant reimbursement rates and stated the CCBHC model
would provide an integrated and sustainably financed model
for care delivery. The Four County Mental Health Center
representative noted the success of its CCBHC “look alike”
program funded through a CCBHC-expansion grant from the
federal Substance Abuse and Mental Health Services
Administration and its goal to become a CCBHC by the end
of the two-year grant cycle.
Neutral testimony was provided by a representative of
the Kansas Department of Health and Environment (KDHE).
The KDHE representative stated concerns with implementing
the CCBHC model by July 1, 2021, and indicated, ideally, 18
months would be needed for implementation. The
representative stated the CCBHC model was discussed at a
high level during the 2020 Special Committee on Mental
Health Modernization and Reform, but establishing the
program would be more complex. The representative stated
the Centers for Medicare and Medicaid Services (CMS) had
requested 18 months to review and approve any Section
1115 waiver amendments or substantial state plan
amendments. The PPS planning and rate-setting process
would involve the completion of multiple steps, including
assessing the impac